NPI 1053798264

Jennifer Kim, MD

Practitioner Surgery Physician Shreveport, LA

Practice location

Address: 1501 Kings Hwy Surgery, Shreveport, LA 71103-4228
Phone: (318) 675-2655
Mailing address: 8600 N State Route 91, Peoria, IL 61615-9541

Registered specialties (2)

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 036153868 (IL)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1053798264
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Apr 2015
Record last updated: 9 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.